What I know, what I don't know and what happens in between

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Monthly Archives: March 2012

I’ve overdosed on caffeine today. It happens occasionally, thought not often. And the intense dizziness ifs back. Connection? I hadn’t thought of it before, but with my mind spinning and rushing off in all directions simultaneously, the paths have crossed and the possibility is presented. All to the sound track of Inside Out by the Traveling Wilburys

Ironic, that given the crisis in the pharmaceutical delivery system in our true north strong and free, that the one one very successful drug delivery system should push me into over dose range. Not that I get my drug from timmies or even the star system. I create it at home with the loving care of my Kurig machine – which, given it is saturday and I have fewer demands and much fewer meeting, allows me to wander into the kitchen and jetson-stye, push a button and get a coffee. But I digress…

It has been a rude awakening the past few weeks, to discover that 90% of our injectable drugs come from a single source in Quebec. It seems that no one knew this prior to the looming catastrope. How this happens, I don’t know, and neither does anyone else I am dealing with as we try to dance around the titanic avoiding the shifting deck chairs and screaming passengers.

In case you are having trouble following the crisis, simply:

1. Sandoz Canada supplies the majority of generic injectable drugs for the Canadian health system. Drugs for things like treating cancer, pain, cardiac emergencies and for surgery. They also provide a portion of these products to the US market.

2. The FDA warned Sandoz to clean up their act several times last year. They told them that their quality control on injectable was not very quality and they they needed to fix the problems or they would not be able to ship to US.

3. Sandoz didn’t tell us in Canada that they had problems until the 11th hour when they had to shut down production in order to fix the problems. Some drugs the production was only slowed down.

4. Fire in the Sandoz plant last weekend shut the whole thing down.

5. Critical national shortages of essential medications have been seen across the country.

6. Alternative sources have been sought, but regulations to import could delay those supplies

So those are the players and the moves made so far. And now after only a couple weeks of this, I am over dosing on caffeine, eating bread and trying to find a way to let those pushing the drugs know what they will have to work with today without overwhelming them with the mass alert notifications about a bunch of drugs they never use. I am wondering if the successful drug delivery systems can provide some tips on how to make sure we all have the drugs we need when we need them. Tim’s certainly has the idea – a dispensary on every corner, production is clean, quick and fresh. How do we make that work?

OMG – you think nursing school is time consuming and stressful? And the best parts are working 3 days and wearing pajamas to work? no wonder the profession is circling the drain. There seems to be an increasing number of graduates who really don’t know what the job they have just spent thousands of dollars learning to do, is really about. Yes. This is a stressful job. Very stressful in most cases. Sick people have issues. Quite a few. And yes, it IS about them. Get your hair out of your face, take those damn false nails off and wear a shirt that covers your freaky tattoos and belly. You may think because you like working at Starbucks serving demanding customers that delivering a meal tray and following doctors around with a clip board will be fun and fashionable. You would be wrong. There are things you will see that will scar you forever. PSTD will become part of who you are. Coffee and licorice is a regular meal plan.

Grammie always told me that to be a nurse you needed head, heart and hands. None of these things alone was enough or you would be a lopsided nurse lurching crookedly from crisis to crisis. Grammie should know, she was a nurse in the Afore Times for 40 years and then right through the shortages, the plague and the dying off. Her mother, my great-grammie was also a nurse and HER mother before that too! So that means, when I graduate, I will be a 5th generation nurse! Grammie laughs and says we are a dynasty!

Started learning to be a nurse today, official, but my grammie and my mum have been teaching me since I was born I think. Wash your hands! Eat some fiber! Open the windows! Go for a walk! My colouring books were anatomy colouring books and my favourite game was Operation where you got a buzz if you were not steady enough to take out the funny bone. When I learned to sew, I learned how to use a sewing machine and how to hand sew including how to do stitches. When I learned to cook I learned how to sterilize jars and things and how to keep food safe to eat.

But today was the first day of classes and my teacher said that we are going to start with Nurstery – which is the history of nursing up to today. The first reading is called The Lady with the Lamp and is about Florence Nightingale, of course. Grammie and mum told me about her, being nurses, but now I get a chance to read what she wrote and find out all about how nursing got started. I am very excited and proud, cause nursing is a very honourable work, despite what the vids say.

Also my teacher said we should keep a journal of how we are changing into nurses. Real Nurses, she said. And then she said we would learn about Real Nurses later. I wonder if there are unReal Nurses? Maybe I will ask Grammie or mum.

Lately when I finally get home from work I feel like I need to eat chocolate, fat and anything else I can find that is not good for me. Is it a subconscious desire to punish myself for continuing at BHS, or is it I am so used to feeling at the end of my resources that chocolate seems like a reasonable supper choice?

It was another sunny day in the centre of mediocrity where our motto is, ‘We tried’. Handwaving and finger-pointing along with abrupt, raised voice was the strategy used by the aspbergers tainted intensivist to impress upon us all his displeasure. Sure, sure, the night staff screwed the pooch when, as soon as the managerial types were safely tucked in at home asleep, they cancelled the patient transfer from the icu citing, umm, ah – we can’t possibly take that patient. And sure, sure, the early morning crashing patient on the ward who hadn’t been seen since at least 04:00, maybe 24:00 and was last documented as, ‘sleeping comfortably’, needed an icu bed STAT which wasn’t available because the afore said night staff decided they needed to have their rotating nap schedule adhered to instead of taking the post op ent patient from icu. Sure, sure, admitting the crashing patient to that unit would show them – well not exactly since those night staff have already gone home and now the semi-innocent day shift gets shit on by the physician. And yeah, the physician seeing the 3rd MET call on then ward and it isn’t even 9am yet, was having a hard time being heard over the intense intensivist having a hissy fit over where the patients were on the shifting deck chairs.

sigh. Locked in my office, knowing the trickle down of the level of pissedoffedness out there is going to dribble down to the bedsides and that the sniper attacks will continue through the day and likely the night.

Let the stupidity games begin. What? That RRT brought the EKG machine to the bedside and hooked up the patient and ran the EKG that was ordered? WTF! What kind of world is it where a nurse can’t just be in control of everything – if the RRTs start helping out they it is a sign of nurses being replaced and ‘squeezed’. The blurring of boundaries of role activities is now on the list of nursing concerns.

No, no, preventing hospital acquired infections is not a concern, but boy that RT over there is eying my transducers and damn if he isn’t leveling it! How dare he!

Oh and can you please come up with a consistently enforced practice around patients and families using cell phones in the rooms? Because some nurses let them and some nurses don’t and when I, as one of the don’ts tell them they can’t, it makes me look bad. And why do I care? well, because I neeeeed to be in control. And besides BHS has a policy.

Ah yes, back to BHS. and finally as the day twists down, an email pings and instead of ignoring it and walking out the door, I peek and regret my actions. Seriously. A policy on trust. Someone is getting paid $100,000.00+ per year to make this shit up.